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California will allow indoor dining in San Diego and San Francisco as early as next week.
California took some of its first steps on Friday toward easing severe coronavirus-related restrictions imposed amid a summer surge in cases.
Gov. Gavin Newsom unveiled what he described as a simpler plan that would allow some counties, including San Diego and San Francisco, to reopen many businesses indoors as early as Monday under limited circumstances, such as gyms and houses of worship, as well as permit indoor dining. Bars will remain closed in most of the state.
“We’ve learned a lot over the last number of months,” Mr. Newsom said.
Most residents will see little change in California, which has tallied more than 695,000 cases and more than 12,000 deaths as the virus has steadily spread, complicating responses to the state’s other disasters, like the ongoing wildfires.
The new plan sorts the state into tiers, and the most restrictive applies to 38 counties, including Los Angeles and Orange, that are home to more than 80 percent of the state’s population. That tier keeps many kinds of businesses closed, unless they can operate outdoors, and forbids indoor dining. Hair salons, barber shops and malls can reopen indoors with modifications.
About a dozen more mostly smaller and more rural counties are also in less restrictive tiers that allow them to reopen bars and other indoor businesses at higher maximum capacities and with fewer restrictions.
The new plan is based on new daily case numbers per 100,000 residents, as well as positivity rates. In recent months, the state had shifted away from its initial reopening plan to a model in which restrictions were tied to a county’s status on a “monitoring list” of places where the virus was spreading rapidly. Critics called the list overly fragmented and confusing.
Now, counties won’t be able to move to a less restrictive tier unless they have met that tier’s criteria for at least two consecutive weeks.
They’ll be moved to a more restrictive tier if their numbers worsen for two weeks in a row.
“We’re going to be more stubborn this time,” Mr. Newsom said.
The state’s earlier moves to reopen businesses had been criticized for being too hasty and driven by the impatience of some businesses and some smaller, largely rural counties, rather than by evidence.
Two P.R. experts at the F.D.A. have been removed after the fiasco over convalescent plasma.
Two senior public relations experts advising the Food and Drug Administration have been fired from their positions after President Trump and the head of the F.D.A. exaggerated the proven benefits of a blood plasma treatment for Covid-19.
On Friday, the F.D.A. commissioner, Dr. Stephen M. Hahn, removed Emily Miller as the agency’s chief spokeswoman. The White House had installed her in the post just 11 days earlier. Ms. Miller had previously worked in communications for the re-election campaign of Senator Ted Cruz and as a journalist for the conservative cable network One America News. Ms. Miller could not be reached for comment.
The New York Times correspondents Sheila Kaplan and Katie Thomas report that Ms. Miller’s termination came one day after the F.D.A.’s parent agency, the Department of Health and Human Services, terminated the contract of another public relations consultant, Wayne L. Pines, who had advised Dr. Hahn to apologize for misleading comments about the benefits of blood plasma for Covid-19.
“I did recommend that he correct the record,” Mr. Pines said, adding that he wasn’t told why his contract was severed. “If a federal official doesn’t say something right, and chooses to clarify and say that the criticism is justified, that’s refreshing,” Mr. Pines said.
The Department of Health and Human Services denied that Mr. Pines’s contract was terminated because of his involvement in the plasma messaging.
It was “100 percent coincidence,” said Brian Harrison, the department’s chief of staff. “H.H.S. has been reviewing and canceling similar contracts, so I had it sent to our lawyers, who recommended termination. This was routine.”
The F.D.A. had been considering allowing the use of convalescent plasma as a treatment for Covid-19 on an emergency basis, but earlier this month, The Times reported that the decision had been delayed after a group of federal health officials, including Dr. Francis S. Collins and Dr. Anthony S. Fauci, intervened and expressed concern that the available evidence on the effectiveness of the treatment was too weak, prompting Mr. Trump to call the F.D.A. a deep state. Mr. Trump and Dr. Hahn made the inflated claim for the treatment’s value on Sunday, just ahead of the Republican National Convention.
‘We are incredibly concerned’: Local health departments urge the C.D.C. to pull its new guidance on testing.
Two organizations that represent thousands of local public health departments in the United States sent a letter to senior Trump administration officials on Friday asking that they “pull the revised guidance” on virus testing and restore recommendations that individuals who have been exposed to the virus be tested whether or not they have symptoms.
The letter — addressed to Dr. Robert R. Redfield, director of the Centers for Disease Control and Prevention, and Adm. Brett P. Giroir, an assistant secretary of health at the Department of Health and Human Services — was sent by the leaders of the National Association of County and City Health Officials, and the Big Cities Health Coalition. The organizations’ leaders wrote that their members were “incredibly concerned” about the changes.
The C.D.C. quietly modified its coronavirus testing guidelines this week to exclude people who do not have symptoms of Covid-19 — even if they have been recently exposed to the virus.
Experts questioned the revision, pointing to the importance of identifying infections in the small window immediately before the onset of symptoms, when many individuals appear to be most contagious.
After a storm of criticism, Dr. Redfield tried to clarify the agency’s recommendation and said “testing may be considered for all close contacts of confirmed or probable Covid-19 patients.”
The letter sent on Friday said, “As public health professionals, we are troubled about the lack of evidence cited to inform this change. CDC’s own data suggest that perhaps as many as 40 percent of Covid-19 cases are attributable to asymptomatic transmission. Changing testing guidelines to suggest that close contacts to confirmed positives without symptoms do not need to be tested is inconsistent with the science and the data.”
The letter went on to say that while the new guidance allows local or state health officials to make exceptions, it “will make their ability to respond to the pandemic even harder,” allowing skeptical officials or members of the public to blame and question them. “This revision and its resulting impact is adding yet another obstacle for public health practitioners to effectively address the pandemic.”
A Nevada lab confirmed the first coronavirus reinfection in the U.S., a case that included severe symptoms.
A public health laboratory in Nevada has reported the first confirmed coronavirus reinfection in the United States, and the first in the world known to have brought on severe symptoms.
The first three confirmed reinfections in the world were reported this week, one in Hong Kong and two in Europe, all mild.
Reinfection does not surprise researchers, given the millions of cases around the world, but it is not yet clear if such cases — particularly severe ones — are anomalies or will prove common.
The patient is a 25-year-old man in Reno who apparently experienced a second bout of infection just 48 days after his first, according to health officials in Nevada.
Experts have said that even low levels of antibodies and T cells in response to infection should last for a few months and provide some protection against the virus, which appears to have been borne out in the other confirmed reinfections.
The patient in Nevada had a sore throat, cough, nausea and diarrhea starting on March 25. He tested positive on April 18, recovered by April 27, and tested negative twice. He began to feel unwell again on May 28, and three days later sought help for a similar set of symptoms.
He was hospitalized on June 5 for shortness of breath and needed oxygen; an X-ray showed the “ground-glass opacities” typical of Covid-19.
Researchers genetically sequenced the viruses from each bout, and found they were too different to be accounted for by an extended first illness. The findings have been submitted for consideration to the Lancet Infectious Diseases journal.
The researchers did not test the man for antibodies after the first illness, but found that he had them after the second.
Some experts said the severe symptoms could mean that the patient had not developed antibodies after the first infection, or that his immune response was overpowered by a massive dose of virus the second time. It is also possible that he suffered antibody-dependent enhancement, in which the immune response may worsen symptoms on a second encounter.
The findings highlight the need for widespread testing and viral sequencing, said Angela Rasmussen, a virologist at Columbia University in New York who was not involved in the work. “You really are going to need to look at a lot of these cases to try to start to narrow down which hypothesis is probably right,” she said.
States and college towns in the U.S. are now cracking down on student partying.
Across the United States, state and local governments are bearing down on student partying as thousands of cases have erupted with the return of students to college campuses.
With cases spiking in Iowa, particularly among young adults, Gov. Kim Reynolds announced Thursday that the state would shut down bars, breweries and nightclubs in six counties, including the two with the state’s largest concentrations of college students. In Story County, where Iowa State University is, more than 1,000 of the 2,129 total cases have been reported since the start of August. Similarly, Johnson County, home to the University of Iowa, is now averaging more than 100 new cases per day, up from about 25 new cases per day in early August.
On Thursday, Gov. Andrew M. Cuomo of New York outlined criteria that would require campuses to go remote for two weeks. Earlier in the week, campus and city officials in Tuscaloosa, Ala., announced that bars would be shut down for two weeks amid reports that more than 500 University of Alabama students had tested positive since the start of the semester. On Friday, the university reported an additional 481 cases — a daily average of 160 new cases over just the last three days.
And health officials in Butler County, Ohio, announced that they had quarantined all the student athletes who had returned to Miami University, many of whom had attended an off-campus party. The Newark, Del., city council passed an emergency ordinance capping attendance at house parties in an effort to control partying at the University of Delaware.
Here’s what’s happening in schools and universities across the U.S.:
The University of Notre Dame, which pivoted to virtual instruction earlier this month after a spike in infections, announced Friday it will resume face-to-face classes next week amid signs that the surge is receding. Over the past week, the county where the campus is located, St. Joseph, reported about 882 more cases, according to a New York Times database.
Texas Christian University reported more than 470 coronavirus cases in August, which school administrators attributed to parties that occurred last weekend. The university’s vice chancellor for student affairs wrote in a letter to students: “We literally cannot keep up with the pace of the spread we are experiencing this week. So, I ask you again today to live up to our expectations.”
With less than two weeks before the start of school in New Jersey, growing numbers of districts are pulling the plug on in-person instruction, citing teacher shortages, ventilation issues, and late-in-the-game guidance from the state on how to manage virus cases. The state — which had been one of the country’s worst hot spots, but now has a relatively low transmission rate — has left the decision to individual districts.
Cuba announces its first virus-related curfew as cases spike.
Cuba announced its first curfew since the start of the pandemic amid a spike in new cases. Starting Monday, freedom of movement in the capital, Havana, will be suspended between 7 p.m. and 5 a.m.
The island, which boasts the highest doctor-to-patient ratio in the world, seemed close to snuffing out Covid-19 when, for two rapturous days in mid-July, the Ministry of Health reported no new domestic cases. But the numbers have since jumped: The island has registered 241 cases in the past seven days, bringing the total to 3,866, according to a New York Times database.
The curfew is part of a package of new measures that restrict movement. Work in nonessential state jobs will be put on hold, inter-provincial tourism canceled, and supermarkets ordered to sell only to those with identification proving they live in the same municipality.
The shopping rule could worsen food shortages brought about by the pandemic and by hardened American sanctions. While essentials guaranteed to all Cubans — like rice, beans, sugar — have been stable throughout the pandemic, queues of hundreds of shoppers waiting under the searing sun are now a regular feature outside supermarkets. With so many empty shelves, Cubans trek from supermarket to supermarket to search out products like chicken and detergent.
Despite the rise in cases, Cuba has a lower infection rate than most countries in the hemisphere. Cubans are currently 57 times less likely to contract the virus than Brazilians, 13 times less likely than Mexicans, and 42 times less likely than people in the United States, according to data from the University of Oxford.
In other world news:
A judge temporarily removed the governor of the state of Rio de Janeiro in Brazil, Wilson Witzel, as part of an investigation into a suspected kickback scheme for contracts for field hospitals and other pandemic-related expenses. Prosecutors say companies that won the contracts then funneled money through the law firm of Mr. Witzel’s wife, who is also under investigation, to reward him in return. Mr. Witzel accused political rivals of using the justice system to oust him.
India is now the world’s fastest-growing virus crisis, having reported nearly half a million cases in the past week, including at least 75,000 a day on both Thursday and Friday, according to a New York Times database. Packed cities that make social distancing nearly impossible, lockdown fatigue and virtually no contact tracing have allowed the virus to spread to every corner of the country of 1.3 billion people. The country has a total of 3.3 million cases and at least 61,000 deaths.
Ukraine closed its borders to foreigners for 30 days amid a rise in new cases as well as concern that Hasidic Jews traveling to pilgrimage sites risked spreading the virus. Tens of thousands of people normally visit the town of Uman to pay their respects at the grave of Rabbi Tzaddik Nachman of Breslov, who revived the Hasidic movement and died in 1810, around Rosh Hashana, the Jewish New Year, which runs from Sept. 18 to Sept. 20 this year. Israel’s lead adviser on the virus sent a letter to the Ukrainian government supporting the suspension of the pilgrimage this year, Reuters reported.
Chancellor Angela Merkel of Germany believes the pandemic will get worse with the arrival of colder weather. In remarks to reporters on Friday, she said she expected new difficulties when people move indoors. On Thursday, Ms. Merkel and state governors had agreed on a number of new measures, including a minimum fine for not wearing masks and rules designed to lower infections linked to returning travelers. That same day, German health authorities registered 1,571 new infections, many among people believed to have become ill while on vacation abroad. A week ago the country registered more than 2,000 cases in a single day, a number not seen since the end of April.
Many infected children show no symptoms but may spread the virus, a South Korean study finds.
Children who are infected with the virus but show no symptoms may shed the virus for nearly as long as children who are visibly sick, researchers reported on Friday.
The findings, published in JAMA Pediatrics, suggest that the vast majority of infected children appear healthy but still may spread the virus to others. The study is hardly the final word: Research into asymptomatic children has been unfolding rapidly, some studies have been reconsidered, and it still is not clear to scientists how often they may transmit the virus and under what circumstances.
The new study is short on details, and does not indicate whether the virus the children shed is alive and capable of infecting others, or whether older children are more contagious than younger ones.
The researchers in South Korea followed 91 children under age 19 — with a median age of 11 — at 20 hospitals and two isolation facilities between Feb. 18 and March 31. They tested the children’s nose, throat and sputum every three days on average. (Anyone in South Korea who tests positive is sent to a hospital or isolation center.)
Twenty children, or 22 percent, remained symptom-free throughout. In the other children, the symptoms spanned a wide range, from lack of smell or taste to diarrhea, cough, runny nose and fever — “not specific enough for Covid-19 to prompt diagnostic testing or anticipate disease severity,” the researchers wrote. Only two children were sick enough to need oxygen.
Of the children with obvious signs of illness, only six had shown symptoms at the time of diagnosis; 18 developed symptoms later. The remaining 47 had unrecognized symptoms before being diagnosed — which is noteworthy given the tight surveillance in South Korea, the researchers said.
Asymptomatic children continued to test positive for 14 days after diagnosis on average, compared with 19 days in children with symptoms. But the researchers did not try to grow the virus to confirm that the tests were not just picking up remnants of dead virus.
Over all, the findings suggest that screening for symptoms is likely to miss the vast majority of infected children who can silently spread it to others. In their study, 93 percent of the children could have been missed were it not for “intensive contact tracing and aggressive diagnostic testing,” the researchers reported.
The virus complicates rescue and recovery efforts in areas pummeled by Hurricane Laura.
Southwestern Louisiana had experienced its most frightening surge in cases just last month, with the positivity rate of tests reaching 23 percent in mid-July. Weeks of testing and mask-wearing brought the rate down to near 10 percent in late August.
And then Laura showed up, making the immediate priority simply getting everyone to a safe place.
“It was rising water or Covid,” said Dr. Alex Billioux, assistant secretary for the Louisiana Department of Health. “And rising water kills faster.”
Buses taking evacuees out of the storm zone required passengers to wear masks, and were filled in most cases only to half-capacity. Most of the evacuees were then taken to hotel rooms in New Orleans and Baton Rouge rather than the large shelters that usually house people fleeing hurricanes.
All of Louisiana’s state-run community testing sites were shut down on Monday and are expected to reopen next week, and more testing is planned for evacuees staying in hotels.
Dr. Billioux said that when damaged neighborhoods start reopening, there are plans to set up testing sites at stations manned by the National Guard, where in storm recoveries past, returning residents would turn for food or supplies.
The Republican convention presented a distorted account of Trump’s record on the virus.
With no issue threatening Mr. Trump’s re-election like the virus, speaker after speaker at this week’s Republican National Convention painted a narrative of the administration’s virus response that was resplendent with distortions, exaggerations and outright falsehoods.
Addressing the convention on Wednesday night, Vice President Mike Pence proclaimed that “before the first case of the coronavirus spread in the United States, the president took unprecedented action and suspended all travel from China, the second largest economy in the world.”
Mr. Trump did place restrictions on travel from China on Jan. 31, but this porous “ban” ultimately allowed 40,000 people to travel from China to the United States from the end of January to April. It wasn’t until March that similar restrictions were placed on travel from Europe, and by then, a European strain of the virus was already widespread in New York City.
Mr. Trump falsely claimed again that the United States had “among the lowest case fatality rates of any major country anywhere in the world.” (It ranks in the top third around the world.)
He also declared: “We developed a wide array of effective treatments, including a powerful antibody treatment known as convalescent plasma,” which he claimed “will save thousands and thousands of lives.”
In fact, convalescent plasma has been used by doctors for decades, and with virus patients since the early days of the outbreak. Its effectiveness, however, is still in question and has most likely been exaggerated by the administration, and its availability is expected to be limited.
As for a vaccine, it is impossible to predict when one will become available with certainty, given a process that includes securing F.D.A. approval, ramping up manufacturing and setting up a distribution system.
Nevertheless, Mr. Trump said there would be “a vaccine before the end of the year or maybe even sooner.”
Where Americans gathered, the virus followed.
Six months into the pandemic, The New York Times has collected data on more than 500,000 cases linked to thousands of distinct clusters around the United States. Many of those cases turned up in settings that became familiar headlines: cruise ships, prisons, nursing homes, meatpacking plants.
But thousands of other cases emerged in other corners of American life, often with little fanfare. Thirty-five cases at the Belleville Boot Company in Arkansas. Twelve at First Baptist Church in Wheeling, W.Va. Ninety-nine at Saputo Cheese in South Gate, Calif.
The clusters illustrate how the virus has crept into much of life, with a randomness that seems the only rule.
Elsewhere in the U.S.:
Four people who attended the Republican National Convention in Charlotte, N.C. — two attendees, and two people who worked on the event — have tested positive for the coronavirus, Mecklenburg County officials announced. Republican officials said they had “diligent safety protocols in place” in Charlotte.
Even after a warning from the U.S. Postal Service that it may not be able to meet deadlines for delivering last-minute mail-in ballots, more than 20 states still have not changed their policies, potentially disenfranchising thousands of voters whose ballots could arrive too late to be counted in the November election amid the pandemic, an expert told Congress on Friday.
South Dakota added more than 320 new cases and North Dakota added more than 300 additional cases, the second-worst day of the pandemic for each state. Both states set records for new cases on Thursday.
A doctor asks: Is the virus scaring us away from our humanity?
In an essay for The New York Times, Dr. Amaali Lokuge, who works at a hospital in Melbourne, Australia, asks whether the social distancing that is required during the pandemic cuts into our humanity. After an all-to-brief respite, cases in Australia are rising and changing life’s landscape again. He writes:
Here in Victoria, we are just gaining control of a second surge in infections. Similar to the rest of the world, the most vulnerable are being decimated by the virus. The nursing homes have collapsed and the elderly are dying too fast.
Thankfully, the health system still has capacity after months of preparation, but if we don’t control the numbers, the unnecessary deaths will haunt us.
I wonder though, if in trying to suppress it, are we allowing this virus — which is the antithesis of humanity — to win anyway? To me, the biggest threat of SARS-CoV-2 is not its virulence, it is the way it slowly erodes what it means to be human.
First it took away touch and that delicious proximity of a spontaneous hug. Then it took away social gatherings and shared meals. Now with mandatory masks we even lose the warming delight of a smile shared with a stranger.
So even as we wonder and rail against the way the virus got away from us here, it also makes sense. Melbourne is a cosmopolitan, vibrant city which reveled in its connectivity and soul. It seems almost impossible to keep that spirit in check.
The groups gathering at the park are not being selfish or evil, they are just being human. The virus rips through large families like wildfire because even though we try, we can’t suppress the need to touch and hug and be together.
Maybe this is our resistance against a virus which has already taken so much away. Surprisingly, as a health care worker, what worries me most is that we will look back on this time of Covid and be traumatized, not by the fact that so many have died, but by the way we let them die alone.
Reporting was contributed by Ed Augustin, Luke Broadwater, Alexander Burns, Jill Cowan, Sheri Fink, Jeffrey Gettleman, Maggie Haberman, Rebecca Halleck, Shawn Hubler, Mike Ives, Jennifer Jett, Sheila Kaplan, Corey Kilgannon, Sharon LaFraniere, Ernesto Londoño, Claire Moses, Apoorva Mandavilli, Linda Qiu, Motoko Rich, Campbell Robertson, Anna Schaverien, Christopher F. Schuetze, Mitch Smith, Sheryl Gay Stolberg, Katie Thomas, Tracey Tully, Marina Varenikova, Lauren Wolfe and Sameer Yasir.
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